What Is Optum Health Insurance?

Finding avenues to financially support treatment for a substance use disorder can seem challenging. Fortunately, several insurance types exist to help someone in need of treatment. Individuals with Optum insurance can explore their financing options to cover part or all of their recovery. To further explore treatment options for substance use disorders, click here to see which rehab centers accept Optum Health insurance.

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Optum insurance is under United HealthCare Insurance and covers a variety of health conditions along with inpatient and outpatient detox services. Optum provides a variety of coverage depending on the type of plan one gets. Generally, Optum covers rehab for those suffering with Methamphetamine addiction, alcohol addiction, Crack Cocaine addiction, as well as treatment medications that help fight symptoms of withdrawal. Optum Rx provides millions of Americans access to pharmaceutical drugs needed for treatment. The insurance plan fills over 1.6 million prescriptions each year, including those seeking treatment for substance use disorders.

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How Optum For Addiction Treatment Works

In addition to Optum insurance covering substance abuse, individuals are able to utilize the Affordable Care Act, Medicaid, and Medicare to help expand coverage options with Optum. Several financial options for rehab both encourage rehab attendance as well as provide support for continued treatment, depending on one’s plan. Optum Plans are available in the following plans:

  • Optum HMO

  • Optum PPO

  • Optum Perks

  • Optum Rx

  • Optum POS

Depending on the type of Optum insurance plan, the insurance one gets provides partial coverage for treatment medications and can be combined with other insurance types. For additional information of coverage options for addiction treatment, click here to speak with a treatment provider today.

For example, Medicare and Medicaid are available for individuals to use in addition to some Optum insurance plans. Additionally, certain Optum plans are more compatible with certain Medicaid plans, such as plan D for Medicaid. Optum Perks may not be compatible with other insurance types, but can be combined with Medicaid D.

With Optum HMOs, someone battling alcoholism or substance abuse chooses a doctor to visit. The relative would visit to disclose information on the substance use disorder so the doctor can correctly refer him or her to the best facility that supports the insurance. In the case of Optum PPOs and POS, individuals have the freedom to choose the ideal facility for their needs as long as they are within the network.

Being aware of copay or deductibles can help individuals make the best decision so they are aware of how much they are responsible for paying. Contacting a knowledgeable treatment provider can give someone the opportunity to discover the benefits of Optum insurance for substance abuse.

Featured Centers Accepting Optum Insurance for Addiction Treatment

Optum Eligibility Criteria For Addiction Treatment

For detox and other services, they must meet the criteria for levels of care to qualify for the insurance. Criteria includes:

  • The patient is eligible for Optum benefits.

  • The co-occurring disorders can be managed safely.

  • There is an expectation the services will improve the health of the individual seeking it.

  • The individual’s needs are covered by insurance.

For Opioid use disorders, Optum poses other considerations that include, but are not limited to:

  • Optum insurance eligibility.

  • A member having been dependent on Opioids for over a year.

  • The member having received over-the-counter medication for Opioids in the last 2 years.

  • The member is willing to attend structured programs and attends regularly.

Optum’s eligibility will vary based on several factors. For additional questions, contact a treatment provider or visit Optum’s website for more information.

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Optum Copays For Addiction Treatment

Like other types of insurance, the copay would depend on factors such as whether or not the provider is inside or outside of the network, or if the patient has combined any other insurance with Optum. Typical office visits with Optum run between $15 to $25 each visit. Depending on the facility, patients can pay $100 or more. Patients pay a deductible, the amount depending on how much they have paid prior to getting care.

Ready To Get Help?

Optum covers insurance for many facilities. Knowing you or your loved one’s treatment needs or preferences can help make a sound decision about which one to attend. If you or a loved one needs treatment, contact a treatment provider to get more information on rehab options.

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Krystina Murray

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  • Krystina Murray has received a B.A. in English at Georgia State University, has over 5 years of professional writing and editing experience, and over 15 years of overall writing experience. She enjoys traveling, fitness, crafting, and spreading awareness of addiction recovery to help people transform their lives.

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Reviewed by Certified Addiction Professional:

David Hampton

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  • A survivor of addiction himself, David Hampton is a Certified Professional Recovery Coach (CPRC) and a member of the National Association of Alcohol and Drug Abuse Counselors (NAADAC).

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